PATIENTS AND METHODS: Materials and methods: The study involved 120 patients with NAFLD, who were divided into two groups depending on BMI and the control group containing 20 practically healthy individuals.
RESULTS: Results: In patients with NAFLD with comorbid obesity, a statistically significant increase in the relative amount of Firmicutes (52.12 [42.38; 67.39]%) and Firmicutes/Bacteroidetes ratio (3.75 [1.7; 9.5]) against the background of a significant decrease in the amount of Bacteroidetes (13.41 [7.45; 26.07]%); in NAFLD patients with overweight, the relative amount of Firmicutes was 49.39 [37.47; 62.73]%, Firmicutes / Bacteroidetes ratio was 1.98 [1.15; 5.92], and the relative amount of Bacteroidetes was 23.69 [12.11; 36.16]%. In the control group, the distribution of the basic GM phylotypes was significantly different; the relative amount of Bacteroidetes was almost the same as of Firmicutes - 34.65 [24.58; 43.53]% and 29.97 [22.52; 41.75]% respectively, and the Firmicutes/Bacteroidetes ratio was 0.64 [0.52; 1.47].
CONCLUSION: Conclusions: The most statistically significant changes in the composition of IM occur due to the increase in the relative amount of Firmicutes and the ratio of Firmicutes/ Bacteroidetes against the background of a decrease in the relative amount of Bacteroidetes. These changes were directly proportional to the increase in BMI, but had no gender features.
METHODS: Prospective, multicenter, international registry on the management of H. pylori (European Registry on H. pylori Management). All infected and culture-diagnosed adult patients registered in the Spanish Association of Gastroenterology-Research Electronic Data Capture from 2013 to 2021 were included.
RESULTS: A total of 2,852 naive patients with culture results were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 22%, 27%, and 18%, respectively. The most effective treatment, regardless of resistance, were the 3-in-1 single capsule with bismuth, metronidazole, and tetracycline (91%) and the quadruple with bismuth, offering optimal cure rates even in the presence of bacterial resistance to clarithromycin or metronidazole. The concomitant regimen with tinidazole achieved an eradication rate of 99% (90/91) vs 84% (90/107) with metronidazole. Triple schedules, sequential, or concomitant regimen with metronidazole did not achieve optimal results. A total of 1,118 non-naive patients were analyzed. Resistance to clarithromycin, metronidazole, and quinolones was 49%, 41%, and 24%, respectively. The 3-in-1 single capsule (87%) and the triple therapy with levofloxacin (85%) were the only ones that provided encouraging results.
DISCUSSION: In regions where the antibiotic resistance rate of H. pylori is high, eradication treatment with the 3-in-1 single capsule, the quadruple with bismuth, and concomitant with tinidazole are the best options in naive patients. In non-naive patients, the 3-in-1 single capsule and the triple therapy with levofloxacin provided encouraging results.